Extracorporeal shock wave therapy and ultrasound therapy improve pain and function in patients with carpal tunnel syndrome. A randomized controlled trial

BACKGROUND: ultrasound (US) therapy improves symptoms in carpal tunnel syndrome (CTS) patients. Extracorporeal shock wave therapy (ESWT) uses acoustic energy to determine its clinical effects, as US--therapy do. AIM: to compare the short--term efficacy of US and ESWT on mild and moderate CTS STUDY DESIGN: Randomized controlled trial SETTING: University outpatient service POPULATION: Twenty--five patients with mild to moderate CTS, for a total of 42 wrists METHODS: Patients were randomized to receive US, cryo--US or ESWT, and were evaluated for pain and function before treatment started, at the end of treatment, and four and 12 weeks after the end of the treatment. RESULTS: significant improvement was noted in all groups for pain (p<0.05) and functionality (p<0.05). Patients in ESWT group show greater pain improvement at 12--weeks follow--up when compared with both US and cryo--US groups (p<0.05). CONCLUSION: patients affected by CTS might benefit from the application of US, cryo--US or ESWT. Benefits persist 3 months after the end of treatment. CLINICAL REHABILITATION IMPACT: Clinicians might consider the possibility of a short--term non--surgical management for mild--to--moderate CT S.